Eli's Hospice Insider

Published on Wed Jun 15, 2016 PDF

Start double-checking your notices for this essential component.

Starting this fall, a hospice Notice of Election missing a principal diagnosis will get kicked back to you.

Now: “Currently, [NOEs] are being accepted without a principal diagnosis present,” the Centers for Medicare & Medicaid Services says in CR 9575. “Contractors report that this occurs on a high percentage of NOEs.”

In October: Medicare systems will return NOEs submitted without a principal diagnosis starting Oct. 3, according to the CR. The rule will apply to NOEs dating back to January.

Don’t worry if your NOE diagnosis code doesn’t match the one on your claim, says the National Association for Home Care & Hospice.

“There is not an edit comparing the principal diagnosis on the NOE with the principal diagnosis on any corresponding claim(s),” NAHC notes in its member newsletter. “CMS expects that if there is a change in diagnosis from admission, the medical record will contain documentation explaining this.”

Beware: If the doc changes her mind on the principal diagnosis after NOE submission, that’s OK. But if you just enter the wrong diagnosis, that’s an error, NAHC explains. “An error does require correction and often results in loss of days of revenue due to a late NOE,” the trade group warns.